Term
ETOMIDATE
(AMIDATE)
ADULT |
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Definition
Class: Nonbarbituate hypnotic, anesthesia inducing agent.
MoA: Short-acting hypnotic that acts at the level of the reticular activating system.
Indic: Premedication for tracheal intubation or cardio version.
Cons: Hypersensitivity, Labor/Delivery.
AR/SE: Apnea of short term durations, respiratory depression, hypoventilation, hyperventilation, dysrhythmias, hypotension, HTN, nausea, vomiting, involuntary muscle movement, pain at injection site.
DI: Effects may be enhanced by CNS depressants.
Dose: 0.2 - 0.6 mg/kg IV over 30 to 60 seconds. (typical adult dose is 20mg). |
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Term
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Definition
Class: Nonbarbituate hypnotic, anesthesia inducing agent.
MoA: Short-acting hypnotic that acts at the level of the reticular activating system.
Indic: Premedication for tracheal intubation or cardio version.
Cons: Hypersensitivity, Labor/Delivery.
AR/SE: Apnea of short term durations, respiratory depression, hypoventilation, hyperventilation, dysrhythmias, hypotension, HTN, nausea, vomiting, involuntary muscle movement, pain at injection site.
DI: Effects may be enhanced by CNS depressants.
Dose: 0.2 - 0.4 mg/kg IV/IO over 30 to 60 seconds for RSI (older than 10 years of age), 1 time only. Maximum dose 20 mg. |
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Term
SUCCINYLCHOLINE
(ANECTINE)
ADULT |
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Definition
Class: Neuromuscular blocker, depolarizing; skeletal muscle relaxant.
MoA: Ultra short-acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 block as manifested by fasciculations.
Indie: Rapid-sequence intubation.
Cons: Acute narrow-angle glaucoma, penetrating eye injury, malignant hyperthermia. Acute injury after multi-system trauma, major burns, or extensive muscle injury. Inability to control airway or support ventilations with O2 and positive pressure.
AR/SE: Apnea, respiratory depression, bradydysrhythmia, tachydsyrhythmia, dysrythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperK (trauma patients).
DI: Oxytocin, beta blockers, and organophosphates may potentiate effects. Diazepam may reduce duration of action.
Dose: 1 - 1.5 mg/kg Rapid IVP. Repeat once if needed.
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Term
SUCCINYLCHOLINE
(ANECTINE)
PEDI
INFANT |
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Definition
Class: Neuromuscular blocker, depolarizing; skeletal muscle relaxant.
MoA: Ultra short-acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 block as manifested by fasciculations.
Indie: Rapid-sequence intubation.
Cons: Acute narrow-angle glaucoma, penetrating eye injury, malignant hyperthermia. Acute injury after multi-system trauma, major burns, or extensive muscle injury. Inability to control airway or support ventilations with O2 and positive pressure.
AR/SE: Apnea, respiratory depression, bradydysrhythmia, tachydsyrhythmia, dysrythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperK (trauma patients).
DI: Oxytocin, beta blockers, and organophosphates may potentiate effects. Diazepam may reduce duration of action.
Dose: Pedi; 1 - 1.5 mg/kg Rapid IVP/IOP. Repeat once if needed.
Infant; 2mg/kg Rapid IVP/IOP. |
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Term
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Definition
Class: Benzodiazepine, short/intermediate acting; schedule IV drug.
MoA: Reversibly interacts with gamma-amino butyric acid (GABA) receptors in the CNS causing sedative, anxiolytic, amnesic, and hypnotic effects.
Indie: Sedation for medical procedures (eg, intubation, ventilated patients, cardioversion).
Cons: Acute narrow-angle glaucoma, shock, coma, alcohol intoxication, overdose, depressed vital signs. Concomitant use with barbiturates, alcohol, narcotics, or other CNS depressants.
AR/SE: Headache, somnolence, respiratory, depression, respiratory arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at the injection site.
DI: Should not be used in patient who have taken CNS depressants.
Dose: 2 - 2.5mg slow IVP(over 2-3 min). May be repeated to a max of 0.1mg/kg.
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Term
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Definition
Class: Benzodiazepine, short/intermediate acting; schedule IV drug.
MoA: Reversibly interacts with gamma-amino butyric acid (GABA) receptors in the CNS causing sedative, anxiolytic, amnesic, and hypnotic effects.
Indie: Sedation for medical procedures (eg, intubation, ventilated patients, cardioversion).
Cons: Acute narrow-angle glaucoma, shock, coma, alcohol intoxication, overdose, depressed vital signs. Concomitant use with barbiturates, alcohol, narcotics, or other CNS depressants.
AR/SE: Headache, somnolence, respiratory, depression, respiratory arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at the injection site.
DI: Should not be used in patient who have taken CNS depressants.
Dose: Pedi; 0.1 - 0.3mg/kg IV/IO (Max single dose of 10mg). |
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Term
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Definition
Class: Benzodiazepine, long-acting; sedative-hypnotic; anticonvulsant; schedule IV drug.
MoA: Potentiates effects of inhibitory nuerotransmitters. Raises the seizure threshold. Induces amnesia and sedation.
Indie: Acute anxiety stress and agitation, acute alcohol withdraw, muscle relaxant, seizure activity, sedation for medical procedure(eg, intubation, ventilated, cardioversion), may be helpful in acute symptomatic cocaine overdose.
Cons: Hypersensitivity, narrow-angle glaucoma, myasthenia gravis, respiratory insufficiency, coma, head injury.
AR/SE: Dizziness, drowsiness, confusion, headache, respiratory depression, hypotension, reflex tachycardia, nausea, vomiting, muscle weakness, tissue nacrosis, ataxia, thrombosis, phlebitis.
DI: Incompatible with most drugs, fluids.
Dose: Seizure: 5-10mg IV q 10-15 min PRN (5mg over 5min)(Max dose: 30mg)
Premedication for Cardioversion: 5-15mg IV over 5-10min prior to CardioVert. |
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Term
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Definition
Class: Benzodiazepine, long-acting; sedative-hypnotic; anticonvulsant; schedule IV drug.
MoA: Potentiates effects of inhibitory nuerotransmitters. Raises the seizure threshold. Induces amnesia and sedation.
Indie: Acute anxiety stress and agitation, acute alcohol withdraw, muscle relaxant, seizure activity, sedation for medical procedure(eg, intubation, ventilated, cardioversion), may be helpful in acute symptomatic cocaine overdose.
Cons: Hypersensitivity, narrow-angle glaucoma, myasthenia gravis, respiratory insufficiency, coma, head injury.
AR/SE: Dizziness, drowsiness, confusion, headache, respiratory depression, hypotension, reflex tachycardia, nausea, vomiting, muscle weakness, tissue nacrosis, ataxia, thrombosis, phlebitis.
DI: Incompatible with most drugs, fluids.
Dose: Pedi; Seizure activity: 0.2mg/kg to 0.5mg/kg slow IVP q 2-5min up to 5mg (Max dose 10mg/kg).
Rectal diazepam: 0.5mg/kg via 2" rectal cath and flush with 2-3ml air after admin. |
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Term
ROCURONIUM
(ZEMURON)
ADULT |
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Definition
Cl: Nondepolarizing neuromusclular blockade
MoA: Antagonizes acetylcholine at the motor end plate producing skeletal muscle paralysis.
Indi: RSI
Cons: Known sensitivity to bromides Use with Caution with heart & liver disease.
AR/SE: Bronchospasm, wheezing, rhonchi, respiratory depression, apnea, dysrhythmias, tachycardia, transient hypo and hypertension, nausea vomiting.
DI: Use of inhalation anesthetics will enhance neuromuscular blockade.
Dose: 0.6 - 1.2mg/kg IV/IO. |
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Term
ROCURONIUM
(ZEMURON)
PEDI |
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Definition
Cl: Nondepolarizing neuromusclular blockade
MoA: Antagonizes acetylcholine at the motor end plate producing skeletal muscle paralysis.
Indi: RSI
Cons: Known sensitivity to bromides Use with Caution with heart & liver disease.
AR/SE: Bronchospasm, wheezing, rhonchi, respiratory depression, apnea, dysrhythmias, tachycardia, transient hypo and hypertension, nausea vomiting.
DI: Use of inhalation anesthetics will enhance neuromuscular blockade.
Dose: Pedi; (older than 3 months) 0.6 - 1.2mg/kg IV/IO |
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Term
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Definition
Cl: Neuromuscular blocker, nondepolarizing
MoA: Neuromuscular agent with intermediate duration of action that competes with acetylcholine for receptors at the motor end plate, resulting in neuromuscular blockade.
Indi: RSI
Cons: Acute narrow-angle glaucoma, penetrating eye injuries, inability to control or support ventilations with O2 and positive pressure, newborns, myasthenia gravis, hepatic or renal failure.
AR/SE: Weakness, prolonged neuromuscular block, bronchospasm, apnea, dysrythmias, bradycardia, tachycardia, PVC's, transient HoTN, cardiac arrest, excessive salivation.
DI: Use of inhalation anesthetics will enhance neuromuscular blockade.
Dose: 0.1 - 0.2mg/kg IVP, maint; within 45 - 60 min: 0.8 - 1.2mg/kg IVP. |
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Term
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Definition
MoA: Neuromuscular agent with intermediate duration of action that competes with acetylcholine for receptors at the motor end plate, resulting in neuromuscular blockade.
Indi: RSI
Cons: Acute narrow-angle glaucoma, penetrating eye injuries, inability to control or support ventilations with O2 and positive pressure, newborns, myasthenia gravis, hepatic or renal failure.
AR/SE: Weakness, prolonged neuromuscular block, bronchospasm, apnea, dysrythmias, bradycardia, tachycardia, PVC's, transient HoTN, cardiac arrest, excessive salivation.
DI: Use of inhalation anesthetics will enhance neuromuscular blockade.
Dose: Pedi; 0.1 - 0.3mg/kg IVP/IOP, maint; within 25 - 35 min: 0.01 - 0.05mg/kg IVP/IOP. |
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